癌症的活组织检查并不会促进癌症的扩散

近日，来自梅奥诊所的研究人员通过对超过2000名胰腺癌病人进行研究表示，人们不必担心进行癌症的活组织检查会促进癌症扩散，相关文章刊登于国际杂志Gut上，该研究表明，相比未活组织检查的病人而言，进行活组织检查的患者或许会有一个较好的预后及较长的生存期。

细针穿刺是一种侵入性最小的技术，研究人员利用该技术来提取肿瘤组织中的细胞，然而长期以来一直有患者和一些医生认为这种做法会促进某些癌细胞扩散；研究者Michael Wallace教授说道，本文研究显示，进行癌症活组织检查是非常安全的，我们每年在美国进行上百万个癌症的活组织检查，仅有1至2个案例研究提示活组织会使得癌症扩散。

活组织检查会为研究人员后期对患者进行疗法提供导向作用，而在某些研究中，在对患者进行手术前用化疗和放疗进行治疗会明显改善患者的预后。对胰腺癌进行手术是一项非常具有挑战性的任务，大部分的患者想确保他们在手术后是否会治愈，但有一项研究表明，9%的接受胰腺癌手术的患者怀疑自己是胰腺癌，最终却发现是良性疾病。

本文研究中，研究人员检查了1998年至2009年11年间进行手术的非转移性胰腺癌患者的医疗数据，并且分析了进行超声内镜引导下细针穿刺活检术（EUS-FNA）的498名患者及1536名未进行活组织检查的患者的总体生存率及胰腺癌特异性生存率；结果显示，在平均21个月时间内，有285名（57%）EUS-FNA组的患者及1167名（76%）的非EUS-FNA组的患者死亡了，而胰腺癌可以作为引发251名（50%）EUS-FNA组患者及980名（64%）的非EUS-FNA组的患者死亡的原因。

最后研究者Wallace说道，非EUS-FNA组患者的平均存活期(median overall survival)为15个月，而EUS-FNA组患者的平均存活期则为22个月；对患者来讲进行活组织检查非常有价值，其可以帮助研究人员不断改善个体的治疗策略，从而为有效改善患者的生存率及生活质量提供帮助。

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The researchers studied pancreatic cancer, but the findings likely apply to other cancers because diagnostic technique used in this study -- fine needle aspiration -- is commonly used across tumor types, says the study's senior investigator and gastroenterologist Michael Wallace, M.D., M.P.H., professor of medicine.

Fine needle aspiration is a minimally invasive technique that uses a thin and hollow needle to extract a few cells from a tumor mass. A long-held belief by a number of patients and even some physicians has been that a biopsy can cause some cancer cells to spread.

While there have been a few case reports that suggest this can happen -- but very rarely -- there is no need for patients to be concerned about biopsies, says Dr. Wallace.

"This study shows that physicians and patients should feel reassured that a biopsy is very safe," he says. "We do millions of biopsies of cancer a year in the U.S., but one or two case studies have led to this common myth that biopsies spread cancer."

Biopsies offer "very valuable information that allow us to tailor treatment. In some cases, we can offer chemotherapy and radiation before surgery for a better outcome, and in other cases, we can avoid surgery and other therapy altogether," Dr. Wallace says.

Surgery for pancreatic cancer is "a very big operation," and "most people should want to make sure they have cancer before they undergo surgery," he says. One study has shown that 9 percent of patients who underwent surgery because of suspected pancreatic cancer actually had benign disease......